Subseptate uterus

Case contributed by Dr Praveen Jha

Presentation

31 year old female with recurrent abortions.

Patient Data

Age: 31
Gender: Female
Modality: Ultrasound

Case shows 3-D depictions of diverging cornu, due to a partial septum dividing upper endometrial cavity, with no fundal dip.

Case Discussion

Case shows utility of 3-D reconstructions in depicting mullerian anomalies, especially bicornuate/septate/sub-septate uterus. Although, cornual divergence angle was obtuse, and dip was not quite substantial, infertility specialist preferred a resection and cavity repair. Radiologically, this appears more as partially bicornuate uterus, although hysteroscopically it was designated as partial septum. This case certainly falls in typical radiological dilemma between partially bicornuate and subseptate as well as arcuate uterus. As we may clinically understand it is, a partially bicornuate uterus would have a fundal dip from external uterine surface, and would require a metroplasty from 'top' and 'septum resection' from cavity. A subseptate uterus can be managed only by hysteroscopic resection as in this case. An arcuate uterus would need nothing.

Conclusively, I agree with infertility specialist of this case being a subseptate uterus although it doesn't strictly fall in inter-cornual angle criteria.

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Case Information

rID: 34300
Case created: 13th Feb 2015
Last edited: 17th Sep 2015
System: Gynaecology
Inclusion in quiz mode: Included

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